Suchergebnisse

At the onset of the Coronavirus Disease 2019 (COVID‐19) pandemic, just as public institutions and businesses closed, research programs performing human participant research (HPR) also largely ceased operations. With the partial ebbing of the pandemic in some areas, universities and healthcare organizations conducting HPR are considering reopening. Whereas guidelines from governmental authorities and medical specialty societies currently exist to help restarting health services and resuming clinical trials, no clear guidance is available to aid resumption of HPR at community‐based observational cohort studies. Indefinite stoppage of observational research at cohort studies carries many drawbacks and its safe resumption is important and feasible. In this narrative review, we describe a potential path forward for safely reopening community‐based observational studies, drawing on scientific knowledge and best practices from a variety of medical and lay sources. We highlight current recommendations regarding pandemic status assessment and the metrics useful for guiding decisions regarding safe reopening/reclosing and for screening and surveillance of COVID‐19 among employees and participants. We synthesize insights from contemporary literature regarding infection prevention and environmental safety into a set of easy to operationalize plans for restructuring HPR. And lastly, we suggest ways in which observational studies can potentially aid the efforts to characterize the pandemic.

Abstract

Background
Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study.


Methods
The cross-sectional study (1998–2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid–femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates.


Results
In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: −0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: −0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength.


Conclusions
Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.